Peer Chart Audits Improve Documentation of Foot Care in Diabetic Patients
Author Information
Author(s): Lisa J Staton, Suzanne M Kraemer, Sangnya Patel, Gregg M Talente, Carlos A Estrada
Primary Institution: University of Tennessee College of Medicine-Chattanooga Unit
Hypothesis
The peer chart audit process itself, without formal educational intervention or feedback, would be associated with improved documentation of foot care.
Conclusion
Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus.
Supporting Evidence
- Documentation of the neurological exam improved significantly (p = 0.001).
- Documentation of the vascular exam improved significantly (p < 0.001).
- Documentation of the skin exam improved significantly (p = 0.005).
- The proportion of patients receiving a well-documented exam increased from 6% to 24% (p < 0.001).
Takeaway
Doctors looked at each other's patient charts to see if they were checking feet for diabetes problems, and they got better at it over time.
Methodology
A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents.
Potential Biases
Improvements might be due to the Hawthorne effect or other concurrent educational activities.
Limitations
The study design limits the ability to directly measure changes in actual clinical practice.
Participant Demographics
Adult patients with diabetes mellitus receiving continuity care by residents.
Statistical Information
P-Value
p = 0.001
Confidence Interval
95% CI 2.09 to 5.75
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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